During a surgical procedure, a patient inadvertently receives an overdose of a non-depolarising neuromuscular blocker. Which combination is the most appropriate reversal agent?

• A Atropine alone
• B Neostigmine alone
• C Succinylcholine + atropine
• D Neostigmine + atropine ✓

Explanation

Neostigmine inhibits acetylcholinesterase, increasing ACh at the neuromuscular junction to displace the non-depolarising blocker, but also causes unwanted muscarinic effects (bradycardia, bronchospasm, increased secretions). Atropine is given concurrently to block these muscarinic side effects. Atropine alone has no effect on nicotinic neuromuscular blockade. Succinylcholine is itself a depolarising blocker and would worsen the situation.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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